Development of Evidence-Based Rubrics and Instructional Videos for Anesthesia Induction Sequences

Safe and effective induction of anesthesia is a vital component of any anesthesia provider’s skill set. Although both typical sequence and rapid sequence induction are common procedures, much variance in technique exists among providers. Clear, standardized rubrics are an important element in teaching these skills. The purpose of this project was to update the typical and rapid sequence induction rubrics for the Southern Illinois University Edwardsville Nurse Anesthesia Program with the current best practice recommendations. To utilize and reinforce observational learning, instructional videos were also created to accompany the updated rubrics. These materials were presented to the student registered nurse anesthetists (SRNAs) in the course NURS 529 - Orientation to Nurse Anesthesia Practicum prior to beginning clinical rotations. The SRNAs completed a 20-question pretest and viewed the rubrics and instructional videos. One week later, the SRNAs completed an identical posttest and overall evaluation of the educational experience. Results showed that scores improved between the pretest and posttest (78% and 89% respectively) indicating a potential gain in knowledge and skills. Survey results indicated overall buy in and acceptance of the new materials by the SRNAs. These results highlight the importance of multimodal learning in mastering critical, high-level skills such as induction of anesthesia

Reinstatement of methamphetamine seeking in male and female rats treated with modafinil and allopregnanolone

Background Sex differences in methamphetamine (METH) use (females>males) have been demonstrated in clinical and preclinical studies. This experiment investigated the effect of sex on the reinstatement of METH-seeking behavior in rats and to determine whether pharmacological interventions for METH-seeking behavior vary by sex. Treatment drugs were modafinil (MOD), an analeptic, and allopregnanolone (ALLO), a neuroactive steroid and progesterone metabolite. Method Male and female rats were trained to self-administer i.v. infusions of METH (0.05mg/kg/infusion). Next, rats self-administered METH for a 10-day maintenance period. METH was then replaced with saline, and rats extinguished lever-pressing behavior over 18 days. A multi-component reinstatement procedure followed where priming injections of METH (1 mg/kg) were administered at the start of each daily session, preceded 30 min by MOD (128 mg/kg, i.p.), ALLO (15 mg/kg, s.c.), or vehicle treatment. MOD was also administered at the onset of the session to determine if it would induce the reinstatement of METH-seeking behavior. Results Female rats had greater METH-induced reinstatement responding compared to male rats following control treatment injections. MOD (compared to the DMSO control) attenuated METH-seeking behavior in male and female rats; however, ALLO only reduced METH-primed responding in females. MOD alone did not induce the reinstatement of METH-seeking behavior. Conclusions These results support previous findings that females are more susceptible to stimulant abuse compared to males and ALLO effectively reduced METH-primed reinstatement in females. Further, they illustrate the utility of MOD as a potential agent for prevention of relapse to METH use in both males and females

Facial Mobility and Recovery in Patients with Unilateral Facial Paralysis

Objective: (a) To quantify longitudinal 3D changes in facial soft tissue movements in adults with unilateral facial paralysis, and (b) to compare the patients’ movements with an age- and sex-frequency matched control group. Settings and Sample Population: Prospective 3D facial movement data of 36 patients and 68 control participants. Patients’ data were collected within 6 weeks of onset of symptoms (baseline) and then at 3 and 12 weeks after baseline. Materials and Methods: The 3D facial movement data were collected during different facial animations. Mean group measurements of displacement, velocity and asymmetry were computed. Two sample t tests were used to test for significant group differences, and linear mixed models were fit to test for significant changes over time in the patient group. Also, 3D dynamic modelling and vector plots were computed to isolate the patients’ abnormal movements and/or paralysis. Results: The patients’ mean baseline movements were significantly less for both the paralysed and contralateral sides of the face with much greater movement asymmetry than the controls. Patients’ mean measures improved significantly from baseline to 12 weeks. The measures were closer to, but fell short of, the control values. Conclusion: In unilateral facial paralysis, the contralateral facial side was affected by the paralysis and may be tethered or limited in its movement by the paralysed side. The comprehensive measurement set and 3D facial mapping effectively tracked patient recovery and isolated paralysed facial regions. The 3D measures can be used for diagnosis and outcome assessment of different treatments.</p

Fusion approach for remotely sensed mapping of agriculture (FARMA):A scalable open source method for land cover monitoring using data fusion

The increasing availability of very-high resolution (VHR; &lt;2 m) imagery has the potential to enable agricultural monitoring at increased resolution and cadence, particularly when used in combination with widely available moderate-resolution imagery. However, scaling limitations exist at the regional level due to big data volumes and processing constraints. Here, we demonstrate the Fusion Approach for Remotely Sensed Mapping of Agriculture (FARMA), using a suite of open source software capable of efficiently characterizing time-series field-scale statistics across large geographical areas at VHR resolution. We provide distinct implementation examples in Vietnam and Senegal to demonstrate the approach using WorldView VHR optical, Sentinel-1 Synthetic Aperture Radar, and Sentinel-2 and Sentinel-3 optical imagery. This distributed software is open source and entirely scalable, enabling large area mapping even with modest computing power. FARMA provides the ability to extract and monitor sub-hectare fields with multisensor raster signals, which previously could only be achieved at scale with large computational resources. Implementing FARMA could enhance predictive yield models by delineating boundaries and tracking productivity of smallholder fields, enabling more precise food security observations in low and lower-middle income countries.</p